title: [Total debranching through mini-sternotomy].
abstract: Aneurysms of the aortic arch are technically challenging to repair with thoracic endovascular aneurysm repair (TEVAR). Various optional techniques such as debranching or hybrid TEVAR enable landing zones to extend, however, there is still room for improvement. We have performed total debranching to facilitate TEVAR with adequate central neck length more than 2.5 cm. In summary our procedure has 3 features:mini-thoracotomy to minimize its surgical stress which might cause post-operative respiratory failure, side-to-side anastomosis of trifurcated graft with ascending aorta to avoid its kinking after chest closure, and the usage of Pruitt-Inahara shunt tube during anastomoses of the carotid artery.
authors.affiliation: Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ujihira
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Morishita
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shibata
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Saga
authors.forename: Toshio
authors.initials: T
authors.lastname: Baba
authors.forename: Toru
authors.initials: T
authors.lastname: Mawatari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D056346:Sternotomy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods